Nail fungus (onychomycosis)

The fungus damages both part and the whole of the nail, including the nail plate, the nail bed and the root of the nail. The infection develops slowly, causing the nail to change color, thicken, and bend. Concomitant signs may be skin lesions on the fingers, peeling, itching and redness. Over time, the nails become so deformed that they interfere with, for example, wearing the usual shoes.

Most often, the fungus affects the toenails. The medical name is onychomycosis. It is mainly found in the elderly and rarely in children. In most cases, nail fungus develops under the influence of the dermatophyte fungus, which also affects the skin. Sometimes the disease is caused by other types of fungi.

In mild cases, nail treatment may not be necessary. To determine the exact cause of the infection and rule out other possible diseases, a dermatologist will analyze the cut nail. Nail fungus can be cured, but sometimes it takes several months. Antifungal drugs come in the form of pills and nail polish. In the case of advanced nail fungus, they resort to surgical removal of the nail. There is also a method of laser treatment.

Signs and symptoms of nail fungus

The most common symptom of onychomycosis is discoloration and deformation of the nails. The nail can turn white, black, yellow or green. Usually, nail fungus is not of great concern at first and in most cases does not present with complications. If the infection is left untreated, pain in the affected nail may develop. Toenail fungus makes it difficult to walk and wear shoes, and if your fingernails are affected, it can be difficult to write.

As onychomycosis develops, other symptoms appear, for example, the nail may become brittle, loose, or completely flake off the nail bed. If left untreated, the fungal infection can spread to the skin of the fingers and the interdigital spaces. White or yellow spots may appear on the nail bed and the skin around the nail may flake off. All these changes can be seen in the photo of nail fungus.

Causes of nail fungus

nail fungus photo

The most common cause of toenail damage is a fungal infection of the skin, such as a fungus on the foot. Usually, the foot fungus grows on the skin between the toes, causing it to become red, scaly, and itchy. Fungi grow and multiply rapidly in hot and humid environments, so prolonged wearing of sneakers or sweaty feet increases the chances of developing an infection. In about a third of people with yeast infection of the feet, nail decay occurs.

The nail fungus can be caused by an infection caused by the candida yeast, which is also responsible for diseases such as vaginal thrush or stomatitis. The likelihood of developing nail fungus is higher if a person has to wash their hands often or keep their hands in water for a long time at work. Moisture exfoliates the skin at the base of the nail, making it easier for fungi to access the nail. The risk of developing candidal nail lesions is higher with certain diseases, namely:

  • diabetes mellitus or psoriasis;
  • weakened immunity, for example with HIV;
  • poor general health.

Other factors that may increase your risk of developing nail fungus include:

  • wearing false nails;
  • nail damage;
  • constant biting of the nails;
  • live in a hot and humid climate;
  • smoking.

With age, the likelihood of developing nail fungus increases. Sometimes the fungus appears for no apparent reason.

Treatment of nail fungus

In mild cases, treatment may not be necessary. However, if left untreated, the infection can spread to other fingernails and the skin on your toes and hands. To get rid of nail fungus as quickly as possible, it is important to follow simple rules: give up shoes with sweaty feet, cut toenails and carefully monitor foot hygiene.

With the use of medication, a new healthy nail will start to grow at the base of the nail bed, indicating that the treatment is helping. The old affected nail will grow back gradually and can be cut in a few months. If after 2-3 weeks of treatment the new nail does not start to grow, you should see a doctor. It is impossible to stop using prescribed medications without consulting a doctor, as this can lead to the return of the infection.

Foot care tips for toenail fungus

Below you will find tips on how to contain the infection during and after treatment.

  • keep the feet dry and cool, socks and shoes must allow the feet to "breathe";
  • wear clean cotton socks and try to wear sneakers as little as possible;
  • start treatment for foot fungus at the first signs of damage to prevent the infection from spreading to the nails;
  • cut nails correctly;
  • remove the affected areas of the nails with separate scissors to avoid spreading the infection;
  • wear appropriately sized shoes with low heels and a wide toe;
  • putting on clean slippers in a public shower;
  • if walking is difficult due to thickened nails, consult a dermatologist;
  • it is advisable to get rid of old shoes which may be contaminated with fungal spores.

Medicines for nail fungus

advanced stage of toenail fungus

When an antifungal tablet is taken, the medicine reaches the nail through the bloodstream. Most often, terbinafine and itraconazole are prescribed for nail fungus, which are very effective drugs. However, it takes several months of treatment to get rid of the infection completely. If treatment is not completed, the infection may come back.

The advantage of the pills is that they will simultaneously help to get rid of all associated fungal infections, such as fungus from the feet. Possible side effects of antifungal pills:

  • headache;
  • itching;
  • loss of taste;
  • nausea;
  • diarrhea.

Topical remedies for nail fungus

Antifungal nail polish can be used instead of pills. It is not as effective as the pills because the drug is applied to the affected nail and has to reach the site of infection through it. Often it is not possible to cover the entire lesion. Treatment of a fingernail on one hand can take about six months, on a fingernail - up to a year.

To remove the affected nail plates, you can use a paste containing 40% urea. This paste is sold over the counter without a prescription. In the evening, the paste is gently applied to the affected nails, which are then covered with a bandage overnight. In the morning, the paste is washed off, and in the evening the nail is filed according to the instructions and the procedure is repeated. In about two weeks, the nails affected by the fungus will dissolve.

This is a painless procedure that allows you to remove the affected nail plate and get rid of the fungus. He avoids taking medication for several months and painful surgeries. After the nail plate has dissolved, an antifungal varnish should be applied to the nails twice a week so that the new nail does not get infected.

Surgery and laser treatment of onychomycosis

In cases of advanced nail fungus or severe pain, surgical removal of the nail may be recommended if other treatments have failed. After the operation, over time a new one will develop at the site of the removed nail, but it may take a year or more.

Another method of treating advanced nail fungus is laser treatment. The laser emits powerful light energy that kills the fungus. Research results have shown this method of treatment to be safe and effective, with some studies reaching 90% effectiveness after 3 months. However, there is little data on the long-term effectiveness of this method, as most studies have followed people for only 3 months. To achieve long-lasting results, you need to undergo treatment every 3 months for up to a year. This procedure can be expensive.

The need for treatment and the choice of drug should be consulted with a dermatologist. Once the infection is cleared, the nail may not return to its original appearance. In these cases, pieces of the nail are taken for analysis to determine if the infection has persisted in the thickness of the nail despite treatment.